Number of patients with a daily attack frequency equal or inferior to two for the period going from two days after third injection to four days after the third injection [ Time Frame: 2009 ] [ Designated as safety issue: No ]

total number of attacks on the J1-J15 period [ Time Frame: 2009 ] [ Designated as safety issue: No ]

percentage of patients with a 50% or more decrease in attacks frequency at J15 [ Time Frame: 2009 ] [ Designated as safety issue: No ]

percentage of patients reaching a remission at J30 defined as an absence of attacks for seven days or more [ Time Frame: 2009 ] [ Designated as safety issue: No ]

interval between the first injection and appearance of a remission [ Time Frame: 2009 ] [ Designated as safety issue: No ]

percentage of patients suffering from chronic CH, having reached a daily attack frequency equal or inferior to two, presenting a recurrence of attacks after J15, defined as more than two attacks per day [ Time Frame: 2009 ] [ Designated as safety issue: No ]

number of patients (episodic or chronic) presenting a daily attack frequency equal or inferior to two at J30 [ Time Frame: 2009 ] [ Designated as safety issue: No ]

number of chronic patients presenting a daily attack frequency equal or inferior to two at J90 [ Time Frame: 2009 ] [ Designated as safety issue: No ]

the aim of tis study is to demonstrate the efficacy of cortivazol injections at the level of the greater occipital nerve to diminish the frequency of cluster headache (episodic or chronic) attacks during an active period. Injections will be used in adjunct with oral verapamil.

Detailed Description

Cluster headache is characterized by unilateral attacks of severe periorbital pain accompanied by autonomic symptoms and restlessness. Though patients may respond to the standard prophylactic treatment of verapamil, some are refractory and continue to suffer from numerous attacks, with a limit of two doses of subcutaneous sumatriptan per day. Some patients also have contra-indications to standard prophylactic or acute treatments. Other preventive treatments like systemic steroids, lithium and methysergide may cause significant side effects. We intend to show the efficacy of occipital nerve injections with cortivazol, in adjunct to verapamil, in cluster headache patients. We expect a diminution of attack frequency over two weeks, with a protocol of three injections separated by two or three days each. Tolerance and safety will be examined.